Your opinion of police officers.

DragonClaw

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I went out on a ride along (A little farther back) and there was a semi and 2 passenger vehicles involved. They had to extricate one of the drivers (I didn't even see the other car) and the semi went about 40 feet off the road into mud trying to dodge these two cars (apparently).

The driver of the semi was mostly fine, nothing major, but he was shaken about thinking he'd severely injured or killed someone. We'd talked to him and he refused transport.

The other driver couldn't remember much about the incident and had a decent amount of beer cans in the floorboard. He had some pain. He was going to be transported.

We are trying to transport him sooner rather than later and an officer had spoken to the semi driver and apparently convinced him to be transported.

The medics were pretty irritated because they'd already spoken to him and he was "Fine" (Decided on his own to not go, no major obvious injuries) and now they had another person to handle who was less of a priority.

Were they right to be upset (They didn't have a freak out or an argument, more like muttering to themselves)? I think the consensus was that the police had "Overstepped" Their bounds when they already had their hands full.

In my inexperienced opinion, I can see why they'd be upset, but at the same time, see why the police officer would have done so. Some injuries aren't very obvious (Not saying the medics were noobs and I know more than they do), but what would you think of this?
 

mgr22

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That's not the kind of call I'd judge from a distance. I'll just point out that it's EMS's job to transport patients who think they need to go to a hospital for emergent care. Also, in general, it's riskier for patients and EMS when there are refusals.

Who knows why that guy changed his mind? Maybe the cop had something to do with it, maybe not. There were many times when LEOs helped me convince patients to go. I was always ok with that.
 

DragonClaw

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That's not the kind of call I'd judge from a distance. I'll just point out that it's EMS's job to transport patients who think they need to go to a hospital for emergent care. Also, in general, it's riskier for patients and EMS when there are refusals.

Who knows why that guy changed his mind? Maybe the cop had something to do with it, maybe not. There were many times when LEOs helped me convince patients to go. I was always ok with that.
Why is it more risky? Risky for whom?

I didn't think the cop was wrong, better safe than sorry right?
 

mgr22

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Why is it more risky? Risky for whom?

I didn't think the cop was wrong, better safe than sorry right?
You sort of just answered your own question. It's safer for patients and providers -- not cheaper, not more convenient, just safer -- when patients agree to be transported once EMS personnel arrive on scene. No matter how competently refusals are handled, there's always a chance of an undetected illness or injury causing an unfavorable outcome. That's bad for everyone involved.
 

DragonClaw

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You sort of just answered your own question. It's safer for patients and providers -- not cheaper, not more convenient, just safer -- when patients agree to be transported once EMS personnel arrive on scene. No matter how competently refusals are handled, there's always a chance of an undetected illness or injury causing an unfavorable outcome. That's bad for everyone involved.
I see. Thinking back on it, the guy probably still had a lot of adrenaline going. He may not feel so great after that subsides.
 

joshrunkle35

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So, you have a triage scenario, where the police worked triage as the lowest trained emergency response providers (which is appropriate) and EMS provided medical response. If EMS disagrees with Triage, they should stay and provide triage and wait for medical response units.
 

DrParasite

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What's the issue? the medic was annoyed that he had to write another chart? just call a second truck if it's that big of a deal, or if their hands are full

In my experience cops call EMS to get an RMA on a patient with minor injuries, because it covers them. or they will recommend someone get transported just because. or if the drunk doesn't go to the hospital, they will threaten to arrest them, and they will be in the ambulance before you are.

At the end of the day, if the patient wants to be transported, it's my job (and your job) to transport them. If I can't due to limited resources, than I need to find a way to get more resources.

Have I transported patients with no complaints simply because the cops told us to transport them and the patient wanted to go? yep, and when the nurse asked why I did, I said because the patient wanted to go, the cops wanted us to take him, and my boss is happier when I transport someone than when I try to find a way not to. He wasn't happy, but understood my position.

Did the cops overstep? ehh, who cares. the patient decided they wanted to go. that's the end of it.
 

StCEMT

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I'm usually not a fan of unnecessary transports. Yeah there is the liability side, but explain and document. I'm all for helping people get a ride set up and a recommendation for an appropriate facility if they don't need an ambulance. They still get the care they need, but they don't get another enormous bill most people can't easily afford.

Transport everyone is "safer" in terms of liability, but it's not a good use of resources. There are plenty of people I don't waste my time explaining options to, but there are a lot of people that want to know before I transport and I will always give them multiple suggestions.

Based on what little given here, would I find it annoying to take someone who went off road and wasn't injured? Yeah... Based off your story, it doesn't seem like he even hit anything. Not really where I want PD stepping in and creating work. But at the end of the day, the truck driver is easy paperwork.
 

CCCSD

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Guess your vaunted Medics (and you), forgot something: that rig driver, who went off the road? He’s a patient. Ever heard of Psychological trauma? Yep. He gets treated also. Too bad he wasn’t bleeding all over so that you could be heros.

Cops assessed the situation pretty well. Maybe they’ve had more years, seen more patients than the crew you rode with...
 

StCEMT

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Guess your vaunted Medics (and you), forgot something: that rig driver, who went off the road? He’s a patient. Ever heard of Psychological trauma? Yep. He gets treated also. Too bad he wasn’t bleeding all over so that you could be heros.

Cops assessed the situation pretty well. Maybe they’ve had more years, seen more patients than the crew you rode with...
Lots of assumptions here....
 

CCCSD

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Nope. Based on the story told, it’s real simple. Medics pissed off they had to transport. Nothing more. They “assumed” quite a bit.

You are assuming the cops had no training. No experience. What do YOU know about them? Isn’t it far better to ensure ALL patients receive care, or are you just bothered that the driver changed his mind and wanted to go to the ER? BTW,that’s a huge decision for him as he’s out wages, time, and work.

Perhaps rather than assuming, you err on the side of the patient...
 

Jim37F

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If the truck driver is truly uninjured and was only talked into going "to get checked out" and has no complaint passed that, yeah I would honestly be a bit annoyed by extra work being made for me by someone else AFTER already assessing and clearing the driver.

Is that what actually happened? I dont know, WE dont know, we weren't there, didnt ser the scene, didnt ser pr talk to the driver or even have any vitals presented to us.

It may be the cop, not knowing the driver was already assessed, in his best "I'm in charge" voice said "Hey go get checked out" (remember for the majority of law enforcement scenes that we're not involved in they HAVE to take charge and be in control, lest situations deteriorate and people get hurt...)
Maybe he thought by being able to write that the truck driver was sent to the hospital he could add charges to the drunk driver that could stick/better ensure jail time vs a non injury wreck.

Maybe the driver had a minor complaint (vague pain without being specific, sore, seat belt burn, etc) and the medic decided to talk him out of going to the hospital (maybe for an altruistic "he doesn't need a doctor, the MD is going to trauma pat him down the same way I just did, tell him to go home, rest, take some tylenol and follow up the next day if not feeling better... I'll cut out the middle man and save this guy a large bill from us and the hospital" or a less altruistic of "hes just bruised, hes not really a patient, def not an ER patient, I dont wanna waste my time writing up a report/transporting this non-injury".

OR MAYBE he felt fine when talking to the medics, but some time later, while the cop is taking his statement on the accident he starts to feel pain or whatever/develop a a complaint now that he didnt have before...

Any one of these scenarios could be true, all of them could be false, but we do not have anywhere near enough information to pass any sort of real judgment on what actually happened. At minimum a full set of vital signs and the drivers chief complaint.

Without so much of those, we're just making wild *** assumptions based on guesses of the full situation.
 

Remi

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Guess your vaunted Medics (and you), forgot something: that rig driver, who went off the road? He’s a patient. Ever heard of Psychological trauma? Yep. He gets treated also. Too bad he wasn’t bleeding all over so that you could be heros.
No it doesn't. That's actually one of the dumbest thing's I've ever heard. Being shaken up is not a medical emergency.

Cops assessed the situation pretty well. Maybe they’ve had more years, seen more patients than the crew you rode with...
That's a pretty bold assumption. What is it based on?
 

DragonClaw

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Nope. Based on the story told, it’s real simple. Medics pissed off they had to transport. Nothing more. They “assumed” quite a bit.

You are assuming the cops had no training. No experience. What do YOU know about them? Isn’t it far better to ensure ALL patients receive care, or are you just bothered that the driver changed his mind and wanted to go to the ER? BTW,that’s a huge decision for him as he’s out wages, time, and work.

Perhaps rather than assuming, you err on the side of the patient...
Guess your vaunted Medics (and you), forgot something: that rig driver, who went off the road? He’s a patient. Ever heard of Psychological trauma? Yep. He gets treated also. Too bad he wasn’t bleeding all over so that you could be heros.

Cops assessed the situation pretty well. Maybe they’ve had more years, seen more patients than the crew you rode with...

I don't assume police aren't properly trained, not sure where you get that idea. I could be trained to treat a traumatic pneumothorax, but if I do, I could still be in trouble if it's not a standing order or if medical control doesn't advise. I could be right, but still be wrong.

I'm not sure why you say treating someone who is bleeding is more heroic than someone who's not, unless it's a jibe regarding an earlier conversion. But even if it was, not sure why you'd find that necessary, and it's not true.

Moving on. I didn't even give vitals on the guy, not sure how can assume that. I can see you falling on one side of the line or the other, but that's conjecture at best. Unless you were there? Not impossible, but I'll put that in the highly unlikely category.

You're basing that on the assumption that the police officer has more experience than the medics. I just don't see how you came to that conclusion.
 

akflightmedic

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Just to throw an entirely different perspective here for you...not that this is our job to think about, however the cop may have had presence of mind to do so as an advocate for the truck driver (patient). Remember, we are all members of a team, this is a team sport. Someone non-EMS may point out something obvious or not so obvious which we inadvertently missed or did not think about. That is ok, it happens. When it does, say thank you and then do not forget the lesson.

As for the semi driver....this is his OFFICE, possibly his HOME. When the driver gets in a crash, at the moment he may be thinking not so clearly or his concern is elsewhere (the other drivers, did they die or get hurt)....once the dust has settled, the reality is this driver's office was just involved in a crash. Are any of you familiar with the rules/regs of the D.O.T and any other agency (Federal or State) which may have guidelines imposed on these guys? Are you familiar with the paperwork and stress which comes post-incident? What about his employer? Or if he is self-employed, what about his chosen insurance carrier?

This accident could have tons of negative impacts on his current and future employment options. If he has even the slightest physical pain at this moment, it behooves him even more to go get checked out now, but sticking strictly to the point I am trying to make...possibly, going to get examined now to have his state of mind, his physical self, and possibly to self-submit for drug/tox screen right then will alleviate any future actions from his employer or from the other patient's themselves. If the other party's insurance carrier manages to see the inside of the court room or even if they try to settle before that, him having had an immediate medical exam along with tox/ETOH screen might simply shut down that.

So long winded, however the cop just may well have had the patient's best interest in mind and truly helped him far more than any EMS'er or ambulance ride, but as part of the team, we should "assist" with our role and let the cop get the credit for the point.
 

DragonClaw

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Just to throw an entirely different perspective here for you...not that this is our job to think about, however the cop may have had presence of mind to do so as an advocate for the truck driver (patient). Remember, we are all members of a team, this is a team sport. Someone non-EMS may point out something obvious or not so obvious which we inadvertently missed or did not think about. That is ok, it happens. When it does, say thank you and then do not forget the lesson.

As for the semi driver....this is his OFFICE, possibly his HOME. When the driver gets in a crash, at the moment he may be thinking not so clearly or his concern is elsewhere (the other drivers, did they die or get hurt)....once the dust has settled, the reality is this driver's office was just involved in a crash. Are any of you familiar with the rules/regs of the D.O.T and any other agency (Federal or State) which may have guidelines imposed on these guys? Are you familiar with the paperwork and stress which comes post-incident? What about his employer? Or if he is self-employed, what about his chosen insurance carrier?

This accident could have tons of negative impacts on his current and future employment options. If he has even the slightest physical pain at this moment, it behooves him even more to go get checked out now, but sticking strictly to the point I am trying to make...possibly, going to get examined now to have his state of mind, his physical self, and possibly to self-submit for drug/tox screen right then will alleviate any future actions from his employer or from the other patient's themselves. If the other party's insurance carrier manages to see the inside of the court room or even if they try to settle before that, him having had an immediate medical exam along with tox/ETOH screen might simply shut down that.

So long winded, however the cop just may well have had the patient's best interest in mind and truly helped him far more than any EMS'er or ambulance ride, but as part of the team, we should "assist" with our role and let the cop get the credit for the point.
I thought there was a rule that said any semi driver involved in a crash had to go to get checked out and get a tox report. Maybe it's a carrier thing, or maybe it's not even a law. I'm not going to pretend to know all the traffic laws or things of that nature.

But yeah, the truck driver did manage to dodge a sizeable tree, as far as I remember, the vehicle was upright. I think he was lucky. As it was described (As best as I can recall), two passenger cars tried to uturn in front of him. But I, of course, didn't see that and I'm not privy to the police report.

There's a lot of variables. Things sure did happen fast.
 

akflightmedic

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I have had the pleasure many times over the years to watch new players in EMS grow from a narrow focused (its black or its white approach) to one which slowly widens and allows considerations of a bigger picture. I truly enjoy being part of the process, watching these critical thinking skills slowly become infused, take root and then expand. Very few of us are the clinician we were 5 years in, 10 years in, 20 years in....we are ever changing. With that in mind, I do think we become better practitioners once we allow ourselves to question ourselves first and foremost, allow others to challenge us (our way of thinking) and then actually listen to them or our inner thoughts and evaluate, and then change our approach; whether it be the care we provide, the care we withhold, or how we view the scene and perspective of others, it surely will benefit us and the patient.

This touchy, feel good reflection brought to you by apparently an aging paramedic who does not feel old or that experienced, yet is slowly running out of friends/mentors who have been in the game longer....LOL.
 

DrParasite

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I thought there was a rule that said any semi driver involved in a crash had to go to get checked out and get a tox report. Maybe it's a carrier thing, or maybe it's not even a law. I'm not going to pretend to know all the traffic laws or things of that nature.
There is no law. a company might have a rule, but there is no DOT regulation that says the driver of a semi needs to "get checked out." Which, for the record, means, the ambulance will send him a bill, the ER will send him a bill, and the ER doc will send him a bill. hopefully workman's comp will cover it all. but if it doesn't, or they don't find that it was necessary, he could be stuck with all the bills. And if he isn't injured, or is only minorly injured, there is a good chance he will wait in triage while all the sicker people are seen before him. Is it good practice for people injured on the job to see a medical professional? absolutely, however it's often better for them to go to the workman's comp doctor than the ER.

To switch this example around, lets say you were dispatched to an assault. the PD was on scene, and the victim says the other person assaulted them. cop investigates, finds no proof other than the individual complainants, find no actual injuries, and advises both parties that he will write up a report, and to stay away from each other. After you, the EMS provider speak to one of the people, you convince them that they need to file assault charges and the other person should be arrested, out of the safety of the victim. Do you think the cop will be happy with the EMS provider?

It's the same situation.

But once the patient decides they want to go, regardless of the reason they changed their mind, it's less stress to just take them to the hospital vs trying to convince them they don't need to go. They can walk to the ambulance, and sit on the bench seat, and it's an easy chart to write up.
Guess your vaunted Medics (and you), forgot something: that rig driver, who went off the road? He’s a patient. Ever heard of Psychological trauma? Yep. He gets treated also. Too bad he wasn’t bleeding all over so that you could be heros.
psychological trauma needs to go to the ER? go to your safe space please. I don't want you triggered.

I'm not saying it's not real... in fact, EMS workers do experience it. What is stupid is to say that it is best treated in the ER. That's probably the last place you want to send a person who is experienced psychological trauma, unless their is an associated physical component, or they are an imminent threat to themselves or others.
Cops assessed the situation pretty well. Maybe they’ve had more years, seen more patients than the crew you rode with...
The cop could have an EMS background, could be an ER doc who moonlights as a cop part time, he could be a part time EMS supervisor whose full time job is in law enforcement; the hat he is currently wearing is one of law enforcement, so that's what his role is.

In this situation, you are so wrong it's not even funny. The cops convinced a guy to go to the hospital, likely because it's easier for them to have him transported, vs them being tied up until the driver figured out what he was going to do with his truck being undrivable. He was being lazy, and passed his work off to the ambulance. seen it happen before, don't even both denying that you never did it when you were a cop, because I'm sure you did. I trust a cop's medical assessment about as far as I can thrown them. Especially if they have never worked on an ambulance. I don't care how many patient's they have seen from their patrol car, they aren't the medical expert on the scene, regardless of what you like to think.
 

GMCmedic

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This can be a legitimate concern in situations with critical patients and youve determined you do not need more resources. Someone changing their mind, changes the resources needed and potentially delays care.

BUT that is not in your control, therefore not really worth stressing about. Those medics, and likely many others need a lesson in "life is more fun when you don't stress over silly stuff".

You stated they spoke to the truck driver, now they're on the hook for a refusal anyway (at least they should be). A BLS report takes no more time to write then a refusal, really neither does an ALS. With the information provided, they are being petty.
 

StCEMT

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Maybe they do have a medical background. I know a few that are former 68W's and stuff. However, even ones that do have an EMT-B background are likely not going to be as proficient in regards to medical calls as a full time, experienced ALS provider.

You're right, it's better if all patients receive care. HOWEVER, appropriate care is what they need. If he does have the usual aches of a low end MVC, workman's comp and the docs they have lined up is more appropriate. If there truly is some time of underlying psych need beyond being shaken up (being shaken up isn't a medical emergency), going to a therapist is probably the more appropriate option.

Erring on the side if patient doesn't mean just be an overpriced taxi and haul them to the nearest ED.
 
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